Missouri touts efforts to improve services to mentally ill

KANSAS CITY, Mo. (AP) — Programs begun in the last two years to improve mental health services in Missouri are making substantial progress but much more work — and more money — are needed, state officials and mental health advocates said.

Spurred by the deaths of 20 children and six adults at a school in Newtown, Connecticut in 2012, Gov. Jay Nixon’s administration began looking to create or expand programs to help those with mentally illness, substance abuse or other behavioral health issues, said Mark Stringer, director of the Missouri Department of Mental Health.

For fiscal year 2014, the state added $10 million to the department’s budget for five programs — community health liaisons; coordinating care in emergency rooms and health centers; and three separate training programs to help law enforcement, the public and families deal more compassionately with the mentally ill.

The money funded 31 Community Mental Health Liaisons to work with law enforcement officers who previously had little choice but to send someone with a behavioral problem to jail or to emergency rooms. Instead, the officers now refer troubled people to the liaisons, who will try to connect them with available services.

Peggy Gorenflo, a liaison with the Tri-County Mental Health Services, works with 34 police and sheriffs’ departments in three northwest Missouri counties. She said the program improved communication between law enforcement and mental health advocates.

“It’s just greatly improved our relationships in the area because I’m able to educate the officers, who didn’t always know how to help these people,” she said, adding that the program has encouraged some officers to seek help for mental health problems they or their family members are confronting.

Under the Emergency Room Enhancement Project, mental health professionals help emergency room managers find services for people who head to the emergency room when they are in crisis. The state said the program has provided services for more than 2,200 people and significantly reduced emergency visits, hospitalizations and arrests while increasing enrollment in treatment programs.

The three training initiatives are aimed at law enforcement, the public and families with mentally ill members, who often need information on best practices to help the mentally ill, Stringer said.

“Many of us have had physical first aid but no one (in the general public) that I’ve ever met has been trained in how to talk to someone in a mental health crisis,” he said. “And the law enforcement mental health first aid teaches officers to know who needs to be in jail, whether they are mentally ill or just public nuisances.”

Missouri’s efforts are in line with many other state and federal mental health initiatives, said Ingrid Donato, chief of the Mental Health Promotion Branch of the federal Substance Abuse and Mental Health Services Administration. She said the agency has partnered with several other federal agencies and states to “up our game” since the Newtown shootings. She said services have improved in many states but lack of resources is always an obstacle.

“The will is definitely there, the funding is a struggle,” she said. “We’re breaking down silos, getting people talking together and working in ways they haven’t before. They get that it’s essential, getting that to happen takes a lot of work.”

Mark Utterback, president of Mental Health America of Eastern Missouri, a nonprofit mental health and advocacy organization, praised the state’s efforts to make mental health care more efficient and to improve training but said the lack of access to mental health care is hurting people.

“There’s always more need, always people who need that care that cannot get it. We haven’t been able to solve that,” he said.

The $10 million for the initiatives is part of the mental health department’s total budget of $1.8 billion. Stringer said the programs have bipartisan support and he expects the funding to continue, but he argues expanding Medicaid health care coverage in Missouri would help more people who are underinsured or uninsured.

Republican legislative leaders in the last session repeatedly stopped any efforts to expand Medicaid eligibility, with critics saying the system needs to be revamped before more people join. Some GOP legislators suggested that an expansion could ultimately cost the state more money, even though states can receive additional federal funding if they increase eligibility for adults.